Perforated diverticulitis requires emergency surgery . This carries significant risks and mortality as high as 15% during the index admission has been reported . It appears that morbidity and mortality related to resections in complicated and uncomplicated disease are reduced in laparoscopic intervention when compared to open . The real question, however, is whether or not there is necessity to perform any resection or whether lavage is sufficient. Our group has established the safety of this procedure on the largest cohort to date24 in a prospective multi-institutional study of 100 patients. We provided convincing evidence that laparoscopic lavage is a reasonable alternative to resection for non-faeculant perforated diverticulitis. We demonstrated a low mortality rate despite patient co-morbidity and disease severity. Benefits of lavage alone included stoma avoidance and decreased wound infection. At up to 36 months follow up it appeared that subsequent resection appeared unnecessary. These findings were confirmed by a similar French trial published this year which demonstrated no excess morbidity or mortality, a reduction in hospital stay and a lower rate of stoma formation. Having established the safety of the new intervention (laparoscopic lavage), our aim now is to translate this well established study design into a protocol for a multi-institutional randomised control trial as we believe that direct comparison is the only way to provide convincing evidence of one modality over another.